In China, in 2009, nearly 100 million people were obese, but around the same time (in 2008), more than 200 million were suffering from undernourishment. While the latter figure has declined since then, this data highlights a seeming paradox of modern life. Hunger and obesity can now exist in the same countries side by side – and both reach a large scale.

Today, in Nigeria, to give another example, 37% of children under 5 are stunted from undernutrition, even as 25% of women age 15-49 are overweight or obese.

In many low-income and middle-income developing nations, however, this apparent contradiction – where a country’s malnutrition challenges simultaneously include both extremes of chronic hunger and obesity – is usually experienced as part of a “nutrition transition.”

In that transition, a combination of urbanization, changes in dietary intake and a growing middle class combines to produce this phenomenon. It becomes easier for many people to obtain unhealthy foods (or suppliers find it easier to reach them), even as some areas of the country or some economic strata of the population continue struggling to access any food at all.

Eventually, this crossover phase ends, as famines become infrequent, agriculture becomes more efficient and more people cross into a stable middle class.

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